| Psychiatric diagnostic evaluation | CPT 90791 | $200.62 |
| Psychotherapy 30 minutes | CPT 90832 | $86.85 |
| Psychotherapy 45 minutes | CPT 90834 | $114.53 |
| Psychotherapy 60 minutes | CPT 90837 | $168.77 |
| ED visit level 1 | CPT 99281 | $309.43 |
| ED visit level 2 | CPT 99282 | $493.73 |
| ED visit level 3 | CPT 99283 | $115.29 |
| ED visit level 4 | CPT 99284 | $172.18 |
| ED visit level 5 | CPT 99285 | $258.27 |
| Critical care, first hour | CPT 99291 | $2,781.96 |
| CT head without contrast | CPT 70450 | $2,098.11 |
| CT head with contrast | CPT 70460 | $2,522.97 |
| CT head with and without contrast | CPT 70470 | $3,168.02 |
| CT neck with contrast | CPT 70491 | $2,843.07 |
| MRI brain without contrast | CPT 70551 | $3,627.8 |
| MRI brain with and without contrast | CPT 70553 | $4,883.95 |
| Chest X-ray single view | CPT 71045 | $394.79 |
| Chest X-ray 2 views | CPT 71046 | $415.16 |
| CT chest without contrast | CPT 71250 | $2,249.43 |
| CT chest with contrast | CPT 71260 | $3,016.7 |
| Lumbosacral spine X-ray | CPT 72100 | $438.44 |
| CT cervical spine without contrast | CPT 72125 | $2,249.43 |
| CT thoracic spine without contrast | CPT 72128 | $2,249.43 |
| CT lumbar spine without contrast | CPT 72131 | $2,199.96 |
| MRI cervical spine without contrast | CPT 72141 | $3,693.76 |
| MRI thoracic spine without contrast | CPT 72146 | $3,693.76 |
| MRI lumbar spine without contrast | CPT 72148 | $3,693.76 |
| MRI cervical spine with and without contrast | CPT 72156 | $4,851.94 |
| MRI lumbar spine with contrast | CPT 72158 | $4,983.86 |
| CT pelvis without contrast | CPT 72192 | $2,036.03 |
| CT pelvis with contrast | CPT 72193 | $2,495.81 |
| Shoulder X-ray | CPT 73030 | $386.06 |
| Humerus X-ray | CPT 73060 | $330.77 |
| Hand X-ray 3 views | CPT 73130 | $338.53 |
| MRI upper extremity joint without contrast | CPT 73221 | $4,057.51 |
| Knee X-ray 1-2 views | CPT 73560 | $304.58 |
| Ankle X-ray 3 views | CPT 73610 | $315.25 |
| MRI lower extremity joint without contrast | CPT 73721 | $3,581.24 |
| CT abdomen with contrast | CPT 74160 | $3,438.65 |
| CT abdomen and pelvis without contrast | CPT 74176 | $4,033.26 |
| CT abdomen and pelvis with contrast | CPT 74177 | $5,306.87 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $5,135.18 |
| MRI abdomen with and without contrast | CPT 74183 | $4,920.81 |
| Abdominal ultrasound complete | CPT 76700 | $1,303.68 |
| Abdominal ultrasound limited | CPT 76705 | $994.25 |
| Retroperitoneal ultrasound complete | CPT 76770 | $994.25 |
| Transvaginal ultrasound | CPT 76830 | $654.75 |
| Scrotal ultrasound | CPT 76870 | $1,112.59 |
| Screening mammography bilateral | CPT 77067 | $547.08 |
| EKG complete | CPT 93000 | $19.34 |
| EKG tracing only | CPT 93005 | $272.57 |
| EKG interpretation only | CPT 93010 | $9.48 |
| Transthoracic echocardiogram complete | CPT 93306 | $2,712.12 |
| Basic metabolic panel (BMP) | CPT 80048 | $166.84 |
| Comprehensive metabolic panel | CPT 80053 | $186.24 |
| Lipid panel | CPT 80061 | $125.13 |
| Renal function panel | CPT 80069 | $161.99 |
| Hepatic function panel | CPT 80076 | $161.99 |
| Urinalysis automated | CPT 81003 | $45.59 |
| Glucose quantitative | CPT 82947 | $68.87 |
| Hemoglobin A1c | CPT 83036 | $39.77 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $126.1 |
| Complete blood count with automated differential | CPT 85025 | $125.13 |
| Complete blood count without differential | CPT 85027 | $98.94 |
| Urine culture identification | CPT 87088 | $74.69 |
| Tissue exam by pathologist level IV | CPT 88305 | $221.48 |
| Office visit, new patient, 15-29 min | CPT 99202 | $81.92 |
| Office visit, new patient, 30-44 minutes | CPT 99203 | $125.15 |
| Office visit, new patient, 45-59 min | CPT 99204 | $186.59 |
| Office visit, new patient, 60-74 min | CPT 99205 | $246.89 |
| Office visit, established patient, 5 min | CPT 99211 | $26.55 |
| Office visit, established patient, 10-19 min | CPT 99212 | $63.71 |
| Office visit, established patient, 20-29 minutes | CPT 99213 | $102.02 |
| Office visit, established patient, 30-39 minutes | CPT 99214 | $144.49 |
| Office visit, established patient, 40-54 min | CPT 99215 | $202.9 |
